Study finds men on long-acting opioids have lower testosterone

OAKLAND, Calif. — Men taking long-acting medications for chronic pain are almost five times more likely to have low testosterone levels, according to a new study by Kaiser Permanente.

The study, which the healthcare system called the first to show a significant difference in risk between short-acting and long-acting opioids, appeared in The Clinical Journal of Pain.

The retrospective study enrolled 81 men between the ages of 26 years and 79 years, who were seen in the chronic-pain clinic at Kaiser Permanente's Santa Rosa Medical Center in California between January 2009 and June 2010. All study participants had been on a stable dose of an opioid for at least three months. Comparing the use of short-acting opioids, which immediately release the medication when taken, and long-acting opioids, which release it slowly, the study found that 74% of the men on the long-acting opioids had low testosterone, compared with 34% of those on the short-acting opioids.

"For years, doctors have been encouraged to prescribe long-acting opioids rather than short-acting opioids because we believe they were safer, had less abuse potential and offered more consistent pain control, but no study has ever been able to support this practice," Santa Rosa Medical Center anesthesiologist Andrea Rubinstein said.

A larger retrospective study of more than 1,500 male pain patients is currently underway, Kaiser Permanente said.